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GARFIELD BEACH CVS, L.L.C.
DSH050599 UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER
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Covered Entity Details
Entity Name
UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050599
Entity Address
2315 STOCKTON BLVD
SACRAMENTO, CA 95817
Medicare Provider Number
050599
Participating Start Date
1/1/1999
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16106
1919 FULTON AVE
SACRAMENTO, CA 95825
Pharmacy Comments
Contract Details
Approval Date
7/5/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cheryl Ann Sadro, Chief Financial Officer
(916) 703-5009
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/5/2022
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